• Journal of Korean Neurosurgical Society
• /
• 제52권4호
• /
• pp.288-292
• /
• 2012

Objective : Microvascular decompression (MVD) for hemifacial spasm (HFS) is a safe and effective treatment with favorable outcomes. The purpose of this study was to evaluate the incidence of delayed cranirve (VI, VII, and VIII) palsy following MVD and its clinical courses. Methods : Between January 1998 and December 2009, 1354 patients underwent MVD for HFS at our institution. Of them, 100 patients (7.4%) experienced delayed facial palsy (DFP), one developed sixth nerve palsy, and one patient had delayed hearing loss. Results : DFP occurred between postoperative day number 2 and 23 (average 11 days). Ninety-two patients (92%) completely recovered; however, House-Brackmann grade II facial weakness remained in eight other patients (8%). The time to recovery averaged 64 days (range, 16 days to 9 months). Delayed isolated sixth nerve palsy recovered spontaneously without any medical or surgical treatment after 8 weeks, while delayed hearing loss did not improve. Conclusion : Delayed cranial nerve (VI, VII, and VIII) palsies can occur following uncomplicated MVD for HFS. DFP is not an unusual complication after MVD, and prognosis is fairly good. Delayed sixth nerve palsy and delayed hearing loss are extremely rare complications after MVD for HFS. We should consider the possibility of development of these complications during the follow up for MVD.

• 동의생리병리학회지
• /
• 제28권1호
• /
• pp.89-93
• /
• 2014

The aim of this study was to investigate that thermal imaging is objective and effective to evaluate the severity of Bell's palsy. We investigated 19 cases of patients in college of Oriental Medicine, Iksan Oriental medical hospital at Wonkwang university who were diagnosed with Bell's palsy. The degree of palsy was evaluated with House-Brackmann grading system(HBGS) before treatment, then the thermal difference of the face was calculated by thermal imaging, and finally the correlation between HBGS and thermal difference was analyzed. The significance correlation was found between HBGS and thermal imaging's thermal difference. According to the images taken from 17 patients' DITI's temperature value and HBGS's palsy grade, they significantly were correlated. As thermal imaging's thermal differences got larger in number, the palsy grade had increased. These results suggest that thermal imaging identified to be a relatively objective examination method for evaluating the severity of Bell's palsy.

• 한방안이비인후피부과학회지
• /
• 제22권2호
• /
• pp.238-250
• /
• 2009

Recurrence of peripheral nerve palsy is unusual, specially in eye. So there's seldom report about recurrent peripheral nerve palsy in eye. We treated a patient who had consecutive oculomotor nerve palsy after recovery of abducent nerve palsy at right eye. The patient visited our clinic for abducent nerve palsy. When he was hospitalized, ophthalmalgia was VAS 4 but it disappeared when he discharged on 21th of June. Although there was, in the case of abduction of eye, no noticeable change during the hospitalization, it was healed after he received outpatient service twice a week until Nov. 3rd. Oculomotor nerve palsy appeared on 24th of November, 2008 and the patient was hospitalized on Nov. 26th. At that time ophthalmalgia was VAS 4, but disappeared when he discharged. When he entered hospital, the length between upper & lower eyelid and MRD 1 were all 0mm. However, when he discharged, the length between upper & lower eyelid was 11mm, and MRD 1, 4mm which were the same lengths as those of the normal left eye. In the case of eye movement, the motion of supraduction, infraduction, and adduction was entirely inhibited when the patient was hospitalized. By the time of discharge, the inhibition of infraduction was recovered after that of adduction, but the inhibition of supraduction was not recovered. This is a very rare case of peripheral nerve palsy, nevertheless he recovered complete twice by acupuncture and herb medicine therapy.

• 한방안이비인후피부과학회지
• /
• 제24권3호
• /
• pp.108-118
• /
• 2011

Objective : This study was designed to evaluate the influence of time from onset of Bell's palsy until commenced Oriental medicine therapy on Bell's palsy. Methods : We investigated 35 cases of patients with peripheral facial palsy who visited Wonkwang University Oriental Hospital from 10th, December 2010 to 31st August, 2011 and classified them as time from onset of Bell's palsy until commenced Oriental medicine therapy. Time from onset of Bell's palsy until commenced Oriental medicine therapy of Group A was within 3 days. Group B was from 4 days to 8 days. We evaluate the treatment effect of each group by House-Brackmann grade before treatment and 1,3 week treatment. Results : 1. There was a statistical difference in period from onset of Bell's palsy until commenced Oriental medicine therapy between Group A and Group B. 2. There was a statistical difference after 1 week treatment in Group B. 3. There was a statistical difference after 3 weeks treatment in both Group A and B.3. After 3 week treatment, there was statistical significant difference in decreased value of House-Brackmann grade between Group A and Group B. Group A showed more recovery compared with Group B. Conclusions : 1. These results suggest that early oriental medicine treatment could be more effective in recovery of Bell's palsy. 2. Further studies will be required to identify the beneficial effect of early oriental medicine treatment in bell's palsy.

• 동의생리병리학회지
• /
• 제21권6호
• /
• pp.1619-1623
• /
• 2007

This study was desiged to investigate the Obesity and Right-left(region) of Patients with Bell's palsy. We measured the sex, age, BMI and pulse diagnosis of 149 patients who were diagnosed as Bell's palsy. The results were as follows : In distribution of sex, the ratio of male was 52.35%(78 cases), female 47.65%(71 cases). The distribution of age revealed that 40s was the most in 50 cases(33.6%). The distribution of region in facial palsy was left 73 cases, right 76 cases(1:1.04). In distribution of region in facial palsy patients with obesity, the ratio of left was 32.86%(49 cases), right 34.23%(51 cases). But facial palsy patients with obesity was the most in 100 cases(67.11%), low weght was 3 cases(2.01%). In distribution of pulse diagnosis in facial palsy patients with obesity, the ratio of huh-mac(虛脈) was 63.64%(42 case), sil-mac(實脈) 36.36%(24 cases). The huh-mac(虛脈) was simlliar to gi-huh(氣虛). So we found that the facial palsy patients with obesity was more gi-huh(氣虛) than with low weght. In distribution of region in facial palsy patients with obesity-huh-mac(虛脈), the ratio of left was 41.38%(12 cases), right 58.62%(17 cases).

• 대한한방내과학회지
• /
• 제30권1호
• /
• pp.129-143
• /
• 2009

Objective : This study was aimed to investigate the general features and differences between obesity and skinniness of patients with Bell's palsy. Methods : We measured the sex, age. BMI. pulse diagnosis and HBGS (House-Brackmann Grading System) of 234 patients who were diagnosed with Bell's palsy. Results and Conclusions : The results with statistical significance were as follows (1) The distribution of age revealed that 40s was the most at 30.8 %: (2) The improvement period in facial palsy patients with sub-paralysis was shorter than whole-paralysis. And in one part the more we treated, the shorter the improvement period was: (3) In distribution of fat rate in facial palsy patients, obesity was the most at 61.37%, low weight 15.88%. So we found that the fatter the patients was. the higher the onset rate was: (4) In distribution of pulse diagnosis in facial palsy patients with obesity. the ratio of Xu mai (虛脈) was 67.06%. Shi mai (實脈) 32.94%. The Xu mai was similar to Qi xu (氣虛). So we found that the facial palsy patients with obesity were more Qi xu than with low weight. In distribution of pulse diagnosis in facial palsy patients with skinniness, the ratio of Chi mai (遲脈) was none. Shuo mai (數脈) was most: (5) In distribution of region in facial palsy patients with obesity-Xu mai. the ratio of left was 45.10%, right 54.90%, but this result was not statistically significant.

• Archives of Plastic Surgery
• /
• 제49권5호
• /
• pp.633-641
• /
• 2022

Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

• 한방안이비인후피부과학회지
• /
• 제21권3호
• /
• pp.200-206
• /
• 2008

Objectives : This study was planned to find the character type of enneagram in patients with Bell's palsy. Methods : Author gave the 26 patients with Bell's palsy the Korean Enneagram Personality Type Indicator(KEPTI). After making out the questionnaire, we got back them. Then author graded questionnaire papers, and classified according to characte type. We finded that type 1 and type 9 show a higher ratio than any other charicter type. Results : The cause of Bell's palsy onset were over work 34.5%, stress 23.1%, over work and stress 19.2%, cold exposure 7.7%, dental treatment 3.8% pregnancy 3.8%, unknown 7.7%. We finded that type 1 and type 9 show higher ratio than any other charicter type. Conclusion : To find the interrelation between the character type of enneagram and Bell's palsy, further reseach is needed continuosly.

• Journal of Acupuncture Research
• /
• 제26권4호
• /
• pp.115-123
• /
• 2009

Objectives : This study was to investigate the effectiveness of bee venom phamacopuncture complex therapy on the sequelae of peripheral facial palsy. Methods : We observed the effectiveness of bee venom pharmacopuncture complex therapy on three patients who have residual symptoms of Bell's palsy although early stage(0 to 3months) elapsed. H-B grade and Yanagiha's total score was used for evaluating the patient. Results : 1. Deviation of the bee venom therapy on the sequelae of peripheral facial palsy, One patient was improved from 19 to 39, another patient was improved from 25 to 40, the third patient was improved from 15 to 26 on Yanagiha's total score. 2. In the bee venom therapy on the sequelae of peripheral facial palsy, compared with baseline, at final, H-B grade and Yanagiha's total score was increased. Conclusions : Bee venom phamacopuncture can be available for relieving residual symptom of bell's palsy after the early stage.

• Journal of Korean Neurosurgical Society
• /
• 제44권6호
• /
• pp.396-398
• /
• 2008

Although the incidence of unilateral abducens nerve palsy has been reported to be as high as 1% to 2.7% of head trauma cases, bilateral abducens nerve palsy following trauma is extremely rare. In this report, we present the case of a patient who developed a bilateral abducens nerve palsy and hypoglossal nerve palsy 3 days after suffering head trauma. He had a Glasgow Coma Score (GCS) of 15 points. Computed tomography (CT) images demonstrated clivus epidural hematoma and subarachnoid hemorrhage on the basal cistern. Herein, we discuss the possible mechanisms of these nerve palsies and its management.